Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study

Abstract

Objective:To evaluate the effect of adalimumab on the frequency of anterior uveitis (AU) flares in patients with active ankylosing spondylitis (AS).Methods:We determined the history of ophthalmologist-diagnosed AU in 1250 patients with active AS who were enrolled in a multinational, open-label, uncontrolled clinical study of treatment with adalimumab, 40 mg every other week for up to 20 weeks. All AU flares were documented throughout the adalimumab treatment period plus 70 days. We compared the rates of AU flares per 100 patient years (PYs) reported during the year before adalimumab treatment with rates during adalimumab treatment, in total and by patient subgroups.Results:The AU flare rates before adalimumab treatment were 15/100 PYs in all patients (n = 1250), 68.4/100 PYs in 274 patients with a history of AU flares, 176.9/100 PYs in 106 patients with a recent history of AU flares, 192.9/100 PYs in 28 patients with symptomatic AU at baseline and 129.1/100 PYs in 43 patients with a history of chronic uveitis. During adalimumab treatment, the rate of AU flares was reduced by 51% in all patients, by 58% in 274 patients with a history of AU, by 68% in 106 patients with a recent history of AU, by 50% in 28 patients with symptomatic AU at baseline and by 45% in 43 patients with chronic uveitis. AU flares during adalimumab treatment were predominantly mild. Two patients with periods of high AS disease activity had new-onset AU during the treatment period.Conclusions:Results of this prospective open-label study suggest that adalimumab had a substantial preventive effect on AU flares in patients with active AS, including patients with a recent history of AU flares.Clinical trials:ClinicalTrials.gov Identifier: NCT00478660.

Uveitis Events During Adalimumab, Etanercept, and Methotrexate Therapy in Juvenile Idiopathic Arthritis: Data From the Biologics in Pediatric Rheumatology Registry

“…Regarding the rate of uveitis flares on monotherapy with ADA, in our study this is with 37 per 1,000 patient-years, actually lower than 150 per 1,000 patient-years in the phase III ADA study for spondyloarthritis (25) and 140 per 1,000 patient-years in the prospective observational study in spondyloarthritis patients (28). Since there is no information available about the uveitis rate per patient-year before treatment in the BIKER registry, it is not possible to decide whether the rate decreased under ADA.…”

“…In 12 JIA patients treated with ADA, Simonini et al showed that those stayed in remission for a longer time compared to JIA patients on infliximab (24). In a phase III study of spondyloarthritis, while not aiming for uveitis treatment, it could be demonstrated that the flare rate dropped from 15 per 100 patient-years in 1,250 patients pretreatment to 7.4 per 100 patient-years undergoing treatment (25). In a long-term followup over 24 months in 94 patients with JIA-associated uveitis, Kotaniemi et al observed a good response in 65% of patients (26).…”

New Treatment Alternatives in the Management of Non-İnfectious İntraocular İnflammations: Biologic Agents

“…45 Adalimumab ile Behçet hastal›¤› d›fl›nda psoriazis, JIA, ankilozan spondilit gibi farkl› endikasyonlarda intraoküler inflamasyonun baflar› ile kontrol edilebildi¤i bildirilmifltir. 35,36,47,48 Biester ve ark. 49 çocukluk ça¤› üveitlerinde yapt›klar› bir çal›flmada, 17'sinde JIA, birinde ise idiopatik üveit bulunan 18 olguluk serilerinde adalimumab ile üveitin tamamen kontrol alt›na al›nma s›kl›¤›n› %88,8 (16/18) bildirmifllerdir.…”

UVEITIS INA RHEUMATOLOGISTS PRACTICE: A ROLE OF TUMOR NECROSIS FACTOR-а INHIBITORS

“…Rudwaleit и соавт. [16] проанализировали оф-тальмологические диагнозы у 1250 пациентов с актив-ным АС, принимавших участие в открытом неконтро-лируемом клиническом исследовании адалимумаба. Авторы сравнивали частоту обострений переднего уве-ита в течение 1 года до лечения адалимумабом и во вре-мя лечения.…”